Organization · Type 2 NPI
Mysore N Shivaram MD SC
Addiction Medicine (Internal Medicine) Physician · Berwyn, IL
Practice location
6901 Cermak Rd
Berwyn, IL 60402-2160
Fax (708) 484-0194
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction Medicine (Internal Medicine) Physician Primary | 207RA0401X | 036044121 (IL) |
Addiction Medicine (Internal Medicine) Physician: An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
About NPI 1679888341
Mysore N Shivaram MD SC's National Provider Identifier is 1679888341, issued on Aug 18, 2010. The primary taxonomy on file is Addiction Medicine (Internal Medicine) Physician (207RA0401X), and the practice location is in Berwyn, IL. The record was last updated on Oct 15, 2014.